An object of the present invention consists in providing an improved tool for a micro-invasive surgical instrument and an improved micro-invasive surgical instrument.
This object is fulfilled through the content of the independent claims.
Refinements are indicated in the dependent claims.
Embodiments of the present invention are based on the idea of configuring a handling device with a rod coupling that can be slid between an assembly position and a predetermined proximal range of working positions in such a way that a proximal end of a shaft blocked in a shaft coupling of the handling device directly or indirectly holds the rod coupling in the predetermined range of working positions. A blocking of the proximal end of a shaft in the shaft coupling of the handling device means, in particular, a blocking with respect to a movement of the proximal end of the shaft parallel to its longitudinal axis. The shaft, in particular, can rotate around the longitudinal axis of its proximal end with respect to the handling device even when it is blocked on the handling device.
A handling device for a micro-invasive surgical instrument includes a gripping device for manual holding and guiding of the handling device, a shaft coupling for detachable mechanical coupling of the handling device with a proximal end of a shaft and a rod coupling, which can slide linearly in the handling device between a predetermined distal assembly position and a predetermined proximal range of working positions for detachable mechanical coupling with a proximal end of a transmission rod, which can at least either slide or rotate in a shaft coupled with the shaft coupling, such that the slidable rod coupling is configured in order to receive or release, in the predetermined assembly position, a proximal end of a transmission rod and in order, with the rod coupling in the predetermined range of working positions, to hold a proximal end of a transmission rod that is inserted into the rod coupling, and such that the shaft coupling is configured in order to block a proximal end of a shaft, which is inserted into the shaft coupling, in a predetermined position in which the proximal end of the shaft holds the rod coupling in the predetermined range of working positions.
The rod coupling can slide linearly along a curved or straight path. The straight path, along which the rod coupling can slide, is in particular parallel to a longitudinal axis of a proximal end of a transmission rod, which is inserted into the handling device or is to be inserted into the handling device. It is understood that the longitudinal axis of a shaft, transmission rod or proximal end of a shaft or transmission rod means, in particular, the axis to which the particular object is rotation-symmetrical or essentially rotation-symmetrical. In the case of a curved shaft or of a pliable transmission rod, these comments refer in particular to their ends, which as a rule are straight or not curved, at least in portions.
The rod coupling is configured in particular in order to hold the proximal end of a transmission rod in a form-locked or force-locked connection in the working range. The rod coupling is configured in particular for coupling with a pliable transmission rod. The predetermined range of working positions of the rod coupling is situated, in particular, proximally from the assembly position. The predetermined working range can be extended, in particular extended by several millimeters. Alternatively, the working range can be small or—in the context of the achievable or employed precision—can include only one position. In addition to the aforementioned assembly position, other assembly positions can be foreseen within a connecting interval, in particular, or within a range (assembly range).
The rod coupling, in addition, can rotate around a longitudinal axis of a shaft that is coupled, or is to be coupled, with the handling device.
A handling device as described here is foreseen and configured in particular for use or combination with a transmission rod, at least either to transmit a translational movement and a corresponding push or pull force or to transmit a rotational movement and a corresponding torque to the distal end of the transmission rod.
The proximal end of a transmission rod, for which the handling device is foreseen and configured, can have a cross-section that is constant within a predetermined range. Torque between the orientation device and/or the rod coupling on the one hand and the proximal end of the transmission rod on the other hand can be transmitted by form-locking through a non-rotation-symmetrical cross-section of the proximal end of the transmission rod. A translational movement and a corresponding force can be transmitted by force-locking or friction-locking between the rod coupling and the proximal end of the transmission rod. A pressure force or pushing force in the distal direction can also be transmitted by form-locking to the proximal end of the transmission rod.
If the proximal end of the transmission rod has a non-constant cross-section in the area foreseen for an arrangement in the rod coupling, a translational movement and a corresponding force can be transmitted alternatively or in addition in form-locked manner between the rod coupling and the proximal end of the transmission rod. In particular, the proximal end of the transmission rod comprises one or more indentations and/or recesses in which the rod coupling can engage.
A handling device as described here also comprises, in particular, a slide bar, which can slide in the handling device between a predetermined distal assembly position and a predetermined proximal working position, such that the slide bar is configured and positioned to be held in the predetermined proximal working position by a proximal end of a shaft that is blocked in the shaft coupling.
The slide bar can slide in particular along a straight line that is parallel to the longitudinal axis of a proximal end of a transmission rod that is inserted or to be inserted into the handling device. The slide bar can produce additional degrees of freedom in designing or building the handling device and a shaft and transmission rod that are intended to be used with the handling device. In particular, the slide bar can bridge a distance between the proximal end of a shaft inserted into the handling device and the distal end of the rod coupling or another site upon which the slide bar acts on the slide coupling. Thereby, in simple and reliable manner, the slide bar can make it possible that, with the shaft locked or blocked in the handling device, the position of the rod coupling is held in the working range in which the rod coupling holds the proximal end of the transmission rod.
In addition, as becomes clear hereinafter, in particular with reference to the embodiments, the slide bar can comprise or assume additional functions. Thus, the slide bar can make possible an especially compact structure for the handling device.
The slide bar comprises in particular a pass-through opening, which extends from the distal to the proximal side, such that the cross-section of the pass-through opening constantly varies in the direction from distal to proximal, at least in portions.
The cross-section of the pass-through opening becomes narrower, in particular, from the distal to the proximal side. At the distal side the pass-through opening accommodates the proximal end of a transmission rod, in particular in any desired orientation. In proceeding from distal to proximal, the cross-section of the pass-through opening varies in such a way that a proximal end of a transmission rod, which originally has any orientation within a predetermined solid angle, is rotated into a predetermined orientation in a movement from the distal to the proximal direction. For this purpose the cross-section of the pass-through opening varies, in particular continuously or in portions continuously.
The pass-through opening of the slide bar comprises, in particular, a glide surface, which is not parallel to the direction in which a shaft and a transmission rod are to be inserted into the handling device. In particular, several glide surfaces are provided. In particular, several glide surfaces are foreseen. Each glide surface can be flat or spiral-shaped in order to cause a rotation into a predetermined orientation or into one of several predetermined orientations during a movement of a proximal end of a transmission rod from distal to proximal in the pass-through opening.
For example, the slide bar comprises in the pass-through opening two flat glide surfaces, so that the pass-through opening narrows in a wedge-shape from distal to proximal. The distance between the two glide surfaces on the distal end of the pass-through opening is selected, in particular, in such a way that the proximal end of a transmission rod can be inserted into the pass-through opening in any desired orientation on the distal end. On the proximal end, the two glide surfaces comprise in particular a distance that is selected in such a way that a proximal end of a transmission rod can be fed entirely through the pass-through opening only in two predetermined orientations that are 180 degrees apart.
The pass-through opening can, alternatively, be configured at the distal end in such a way that the proximal end of a transmission rod can be inserted into the pass-through opening only in an orientation within one or more solid angles, such that a proximal end of a transmission rod with an orientation within one or more small, predetermined dead areas cannot be inserted into the pass-through opening.
Glide surfaces, in particular flat or wedge-shaped glide surfaces directed toward one another, can be easily producible means for automatic rotation of a proximal end of a transmission rod into a predetermined orientation that achieve a reliable effect along with low production costs.
With a handling device as described here, the slide bar can rotate around an axis, in particular with respect to the handling device, such that the slide bar in addition is configured to transmit torque onto a transmission rod coupled with the rod coupling.
In particular, the slide bar can rotate around a longitudinal axis of a proximal end of a shaft inserted into the handling device or of a proximal end of a transmission rod in the shaft. To transmit torque onto a transmission rod coupled with the rod coupling, the slide bar in particular on its proximal end is configured as form-locked with the proximal end of the foreseen transmission rod. For example, the proximal end of the transmission rod comprises a flattening with two parallel surfaces at a predetermined distance, and the slide bar comprises on its proximal end two opposite surfaces at the predetermined distance or a slightly greater distance.
The slide bar is coupled, in particular directly or indirectly, with a rotation wheel or other actuation device on the handling device, by means of which the slide bar and thereby a transmission rod of a shaft inserted into the handling device can be rotated or else torque can be transmitted onto it.
Several functions can thus be integrated into the slide bar, in particular automatic rotation of a proximal end of a transmission rod into a predetermined orientation, locking of the rod coupling and transmission of torque onto an inserted transmission rod. This integration or realization of several functions in the slide bar makes possible an especially simple, reasonably priced, compact and robust structure for the handling device.
With a handling device as described here, the rod coupling includes in particular a movable gripping jaw for holding a proximal end of a transmission rod, such that the rod coupling is configured in such a way that the gripping jaw, with the rod coupling in a predetermined assembly position, can receive or release a proximal end of a transmission rod and can hold a proximal end of a transmission rod in a predetermined range of working positions of the rod coupling.
The rod coupling includes in particular two or more symmetrically disposed gripping jaws. Alternatively, the rod coupling includes only one gripping jaw or one asymmetrical arrangement of gripping jaws. Each gripping jaw can pivot, in particular, around an associated axis between an assembly position and a holding position. With the gripping jaw in the assembly position or with the gripping jaws in assembly positions, a proximal end of a transmission rod can be inserted into the rod coupling and removed from it. With the gripping jaw in the holding position or with the gripping jaws in holding positions, a proximal end of a transmission rod can be held by the gripping jaw or jaws in a form-locked and/or force-locked or friction-locked connection.
In particular, the gripping jaw or gripping jaws are configured to include a claw or a portion with an enlarged cross-section on the proximal end of a transmission rod in order to form a form-locked connection with the proximal end of the transmission rod. In somewhat more general terms, the gripping jaw can comprise a concave area into which a corresponding convex area on the proximal end of the transmission rod can engage. Alternatively, the gripping jaw or jaws can be configured to engage into a tapering or a concave area on or close to the proximal end of the transmission rod in order to form a form-locked connection with the proximal end of the transmission rod. In addition, both the gripping jaw or gripping jaws and the proximal end of the transmission rod can each comprise a convex area (or several convex areas) and in each case a concave area (or several concave areas), such that in each case a convex area is configured on the gripping jaw in order to engage into a concave area on the proximal end of the transmission rod and such that in each case a convex area is configured on the proximal end of the transmission rod in order to engage into a concave area on the gripping jaw.
The handling device can, in addition, include a guide pin and a control groove, such that either the guide pin or the control groove is positioned on the gripping jaw and such that the guide pin engages into the control groove in order to hold the gripping jaw in different positions independently of the position of the rod coupling.
In particular, the guide pin and the control groove are configured and disposed in such a way that the gripping jaw, with the rod coupling in the assembly position, is pivoted away from the foreseen position of a proximal end of a transmission rod and is pivoted into positions in the predetermined working range toward the proximal end of the transmission rod and is in form-locked connection with the transmission rod. In particular, the control groove is positioned non-slidably on the handling device in the direction in which the rod coupling can slide while the guide pin is positioned on the gripping jaw.
The control groove can be rotatable with the entire rod coupling and, in some cases, with the slide bar, in particular around the longitudinal axis of a proximal end of a transmission rod that is inserted or to be inserted into the rod coupling. In the case of several gripping jaws, each gripping jaw in particular comprises one or more guide pins. The gripping jaw or each of several gripping jaws comprises, in particular, two opposite guide pins, which engage into control grooves placed opposite and running parallel.
With a handling device in which the rod coupling includes a movable gripping jaw to hold a proximal end of a transmission rod, and in which the slide bar can slide between a predetermined distal assembly position and a predetermined proximal working position, a surface area in particular is configured on the slide bar in order to form, with the slide bar in the predetermined proximal working position, a mechanical stop for the gripping jaw of the rod coupling, which restricts the predetermined working area.
In particular, a proximal front surface of the slide bar is configured as a stop. Alternatively another area of the surface of the slide bar, which is partly or completely oriented in the proximal direction, can be configured as a stop for a part of the rod coupling disposed proximally from the area.
The handling device is thus, in particular, configured in such a way that the gripping jaw of the rod coupling is contiguous with the surface area of the slide bar that is configured as a stop, when the slide bar is situated in its working position and the rod coupling is situated in the most distal position within the predetermined working range. In particular when the gripping jaw or jaws are disposed on the distal end of the rod coupling, the mechanical stop of the gripping jaws of the rod coupling can constitute a structurally simple and reliable solution on the slide bar.
A micro-invasive surgical instrument includes a handling device as described here, a shaft with a proximal end that is configured for detachable coupling with the handling device, and with a distal end that is mechanically connected or connectable with a tool, and a transmission rod to transmit at least either a force or torque from the handling device to the distal end of the shaft.
The shaft of the micro-invasive surgical instrument can be straight or curved, rigid or flexible. In the case of a curved or flexible shaft, the transmission rod is, in particular, pliable at least in some parts. The tool particularly includes a grasping, dissecting, biopsy or other type of forceps, a scissors or a needle holder with at least two straight or curved clamps, cutting edges or other jaw members, at least one of which is movable. Alternatively, the tool can include another active device, for example a manipulator with a finger or a finger-shaped device or an electrode in hooked shape or some other form. The transmission rod is particularly configured to transmit a tractive and/or pushing force to the tool on the distal end of the shaft. Alternatively or in addition, the transmission rod can be configured to transmit torque and a rotary movement to the tool. The proximal end of the transmission rod has, in particular, a shape that corresponds to a proximal end of a pass-through opening in the orientation device.
The proximal end of the shaft of the micro-invasive surgical instrument is configured in particular, in the predetermined position, to hold the rod coupling directly or indirectly in the predetermined working area.
With the characteristics and properties of the handling device and corresponding characteristics and properties of the shaft and transmission rod, as described here, a simple, rapid and reliable installation and efficient use of the micro-invasive surgical instrument are possible.
With the micro-invasive surgical instrument, in addition, the transmission rod can be configured to transmit torque from the handling device to the distal end of the shaft.
In particular, the tool on the distal end of the shaft can be rotated or turned around its longitudinal axis by means of torque transmitted by the transmission rod from the handling device to the distal end of the shaft. Rotation of the tool independently of the shaft is thereby possible. For example with a micro-invasive procedure with several instruments with cured shafts in a trocar, each individual tool can be turned independently of the orientation of the curved shaft on whose end the tool is mounted.
The proximal end of the shaft is configured, in particular, in the predetermined blockable position, to hold the rod coupling directly or indirectly in the predetermined working range.
With the micro-invasive surgical instrument, the transmission rod, in particular, is further configured to transmit torque from the handling device to the distal end of the shaft.
In particular, the transmission rod is configured to transmit torque from the handling device to a tool on the distal end of the shaft. The transmission rod is thus rigid or inelastic, in particular with respect to pressure or tractive impacts in the longitudinal direction and with respect to torsion. At the same time the transmission rod can be pliable, in particular in the case of an at least partly curved shaft.
With a micro-invasive surgical instrument as described here, the tool and the distal end of the shaft can be detachably mechanically coupled with one another, such that tool, shaft and transmission rod are configured in such a way that the tool is locked on the distal end of the shaft when the position of the rod coupling coupled with the proximal end of the transmission rod is situated in the predetermined working range.
The detachable connection between tool and shaft can improve, or in fact basically make possible, the cleaning of the instrument. The locking of the tool on the distal end of the shaft, if the position of the rod coupling coupled with the proximal end of the transmission rod is situated in the predetermined working range, can make possible a complete dismantling of the instrument merely by releasing the blocking of the shaft on the handling device. This can markedly simplify or improve the handling of the instrument, in particular its dismantling and assembly.
A micro-invasive surgical instrument as described here includes in particular a tool on the distal end of the shaft so that the tool includes a curved jaw member.
In particular, the tool includes two or more curved jaw members. As long as a curved jaw member can be pivoted around a pivot axis, it is curved in particular in a plane perpendicular to the pivot axis or in a plane parallel to the pivot axis or in both directions.
Arched or even screw-shaped curved clamps, cutting edges or other jaw members of micro-invasive surgical instruments are especially suited for some applications. With an application of a tool with two curved jaw members, however, contrary to a tool with two equal or similar, straight or essentially straight jaw members, a rotation by more than 90 degrees (up to 180 degrees) can be required to align the tool correctly in relation to an object. Rotatability of a tool with one or more curved jaw members around a longitudinal axis of a shaft of a tool can therefore be especially advantageous.